Opinion
‘The true face of tobacco is disease,death and horror
by Dr Anula Wijesundere
Chairperson, Sri Lanka Medical Association Expert Committee on Alcohol, Tobacco & Illicit Drugs.
Vice President, Sri Lanka Temperance Association
President, Success, Colombo
Annually, the 31st day of May has been declared by the World Health Organization as the “World No Smoking Day”. The objective of this declaration was to encourage all persons smoking or chewing tobacco to quit for at least 24 hours and also create awareness amongst the people about the dangers and health risks of smoking. The theme this year is “Protecting children from tobacco industry’s interference” The theme is focused in advocating for an end to targeting of children to harmful tobacco products.
The tobacco epidemic is one of the biggest medical, public health, social, environmental and economic threats the world has faced, killing over 8 million people from tobacco use annually. This includes an estimated 1.3 million non-smokers who are exposed to the toxins in tobacco smoke.
Smoking: the global disease burden
The WHO estimates 1.3 billion smokers worldwide of which 800 million are from the developing world.
Globally 8.7 million deaths occur annually out of which 1.3 million deaths occur from second hand smoking.
Globally 11,000 deaths occur daily.
Smoking kills one person every 8 seconds somewhere in the world.
In 2020, 23.3, % of the world population used tobacco: 36.7 % of men and 7.8 % of women.
A loss of 20 years in life expectancy is observed amongst smokers.
The annual healthcare expenditure on diseases related to smoking is US $1.4 trillion
Smoking is the largest, single and preventable cause of death in the developing world.
From World Health Organization (WHO)
https://www.who.int campaign.
WHO Global Report on trends in prevalence of tobacco use 2000 -2025
Tobacco use: The Sri Lankan Scenario
19.4% overall (3.2 million adults), 36.2% of men, and 4.9 % of women currently use tobacco. (1)
9.1% overall (1.5 million adults), 19.7% of men, and < 0.1% of women currently smoked tobacco. (1)
13.4 overall (2.2 million adults), 23.4% of men, and4.9% of women currently used smokeless tobacco. ,(1)
Currently over 1.5 million Sri Lankans smoke 7.74 million cigarettes daily. (2)
Sri Lankans spend Rs 520 million daily or Rs 189.8 billion yearly on tobacco use (2)
20,000 Sri Lankans die annually from tobacco related diseases. (3)
57 people die a day due to tobacco use (3)
Annual health care expenditure related to diseases associated with smoking alone is Rs 89.37 billion. (3)
The above statistics clearly showcase the heavy burden on the state resulting from tobacco use.
From: (1). GATS Global Adult Tobacco Survey. Fact Sheet Sri Lanka 2020.
(2) Sri Lanka Customs and CTC Price Notice Data. Cigarette Sales and Expenditure in 2022 – Compiled by ADIC
(Alcohol & Drug Information Centre)
(3) National Authority on Tobacco & Alcohol. Fact Sheet 2018. Be Free from Tobacco
The Nature and Composition of Cigarettes:
No level of tobacco inhalation is safe for your health. Considering that tobacco kills more than half its regular uses, tobacco is indeed rotten, inside out and outside in… Thus, smoking can be justifiably called suicidal to the smoker. As passive smoking is equally harmful to family members, tobacco can be considered homicidal as well. Furthermore, smoking is extremely teratogenic to the unborn baby and tobacco can therefore referred to as an infanticide too.
Tobacco smoke contains more than 3000 toxic chemicals. Of this number about 300 chemicals are associated with a variety of diseases, while 50 have been proven to be carcinogenic. Among other chemicals, tobacco smoke contains nicotine, toluene, butane, ammonia,cadmium, hydrogen cyanide and carbon monoxide.
The hazards of tobacco inhalation are clearly evident when we realise that its constituents are utilised to produce many toxic compounds. Nicotine is used commercially to make insecticides. Toluene is an industrial solvent while ammonia is found in toilet disinfectants.
Cigarette lighter fluid contains butane while carbon monoxide is the gas that emanates from car exhaust fumes. Cyanide capsules were utilised by the LTTE terrorist suicide carders.
Tobacco and Nicotine –
Nicotine is the single most active ingredient in tobacco with numerous toxic effects. Without nicotine addiction there will be no tobacco industry. This certainly destroys the legal status that smoking is a matter of choice. Nicotine is addictive, psycho active, and induces tolerance. Most importantly, nicotine apart from its toxicity, is carcinogenic, atherogenic, mutagenic and teratogenic.
Smokeless Tobacco / e cigarettes/ vaping devices / electronic nicotine devices.
Sri Lanka faces a mounting crisis as vaping gains popularity among women and schoolchildren. Although the incidence of smoking tobacco among women is very low at < 0.1%, 4.9% of women currently used smokeless tobacco. (1). E cigarettes are banned in Sri Lanka but are smuggled in through air ports and sea ports. And found in several schools
E cigarettes are currently sold and distributed on line as electronic devices which contain liquid nicotine. Their identification is difficult as they are manufactured in various forms as perfume bottles, wrist watches, pen drives and power banks, etc.
Vaping affects students as nicotine exposure can impact learning, memory and attention, and lead to increased risk of addiction to other illicit drugs. Every effort must be made to eradicate this menace and safeguard the future of the nation’s youth.
Smoking and Heart Disease.
Cardio vascular diseases (Heart attacks) are the leading cause of death globally and smoking is indeed a major risk factor for heart attacks.
Smoking promotes formation of cholesterol containing unstable atherosclerotic plaques within the coronary arteries which rupture causing heart attacks.
Smoking increases the level of total cholesterol and the bad cholesterol – LDL
Smoking decreases the good cholesterol – HDL
Carbon Monoxide in smoke reduces myocardial blood supply.
Smoking increases the blood pressure.
The very act of smoking induces angina.
Smoking is an important contributory factor leading to strokes or brain attacks.??
Rupture of atherosclerotic plaques in the aorta can cause sudden death. (repeat)?
Smoking and diseases of the Respiratory System
The toxins within tobacco smoke cause diseases of the respiratory tract by the following detrimental effects.
1.Changing the nature of the mucosal cells lining the respiratory tract and making it pre-cancerous (squamous metaplasia)
2. Destroying the action of the cilia which wafts off pathogens entering the respiratory tract thus promoting disease.
3. Changing the nature of respiratory tract secretions making the secretions thick and viscid.?
The diseases of the respiratory tract associated directly with smoking are-
chronic bronchitis, emphysema and carcinoma of pharynx, larynx and bronchus. Smoking also aggravates bronchial asthma and pneumonia and leads to pulmonary heart disease (Cor pulmonale).
In 1955, Prof Richard Doll & Dr Bradford Hill clearly proved the direct association of smoking with bronchial cancer. The incidence of bronchial carcinoma is twenty times higher among smokers than non-smokers.
Smoking & Cancer.:
Smoking is also directly associated with carcinoma of the tongue, cheek, lips, nose esophagus, stomach, bladder, cervix pancreas, kidney and colon.
Other harmful effects of smoking,
These include gum infection, gastric and duodenal ulceration, peripheral vascular disease with gangrene of toes and osteoporosis, leading to fractures.
Smoking also leads to deterioration of vision from toxic amblyopia and macular degeneration.
Maternal smoking during pregnancy
Maternal smoking can increase pregnancy loss via ectopic pregnancies and miscarriages. It is also very harmful to the unborn baby, resulting in the following detrimental effects in the baby.
Low birth weight babies – small for dates or pre term births with increased risk of illness disability and death.
Congenital abnormalities in the foetus
Poor cognitive function
Development of small tests with less sperms.
Smoking during pregnancy also leads to delay in establishment of breast feeding and poorer quantity and quality of milk produced.
Smoking and male infertility
Smoking can make men impotent by reducing the blood flow to the penis and preventing an erection. Furthermore, smoking produces malformed sperms and reduces sperm counts. Cessation of smoking improves the sperm count and the quality.?
Environmental harm due to tobacco
Tobacco cultivation and consumption results in the pollution of air, water and soil. The cultivation of tobacco requires large amounts of pesticides and fertilisers which can be toxic and pollutes water supplies. Each year tobacco cultivation uses millions of hectares of land leading to soil erosion and global deforestation. Tobacco manufacturing also produces millions of tons of solid waste. Each year, trillions of cigarette butts are littered worldwide, with a significant portion finding their way to the oceans. Clearly tobacco is a global scourge that affects water, air and soil in a most deleterious manner, effecting sustainability and development globally.
Cessation of Smoking
Smoking is the single most preventable cause of death worldwide.
Cessation of smoking is the most cost-effective healthcare intervention.
Prolongs life by at least 20 years.
Doctors and all health care personnel have a major role to play in helping smokers to quit smoking. Simply by telling a smoker to quit smoking is effective in 1 out of 10 addicts quitting the habit.
The advantages of overcoming smoking must be impressed briefly-
To have better health.
Be a role model for the children.
Protect the family from passive smoking.
Save the money wasted on tobacco for the betterment of the family.
Assist the smoker to stop smoking by providing counselling, non-tobacco pastels and treatment with nicotine replacement therapy if available.
The free help line introduced by NATA – “Call 1948 for free from tobacco ” has proved to be helpful and successful in overcoming tobacco addiction. This facility must be certainly be popularised and utilised to its fullest potential in the future.
Ending the tobacco menace
In Sri Lanka the incidence of smoking has decreased as successive governments have prioritised the control of tobacco in the country. Special appreciation must be made of President Maithripala Sirisena who as the Minister of Health gave superb leadership to the campaign against tobacco consumption, earning the wrath of multinational tobacco companies.
Sri Lanka was the first country in Asia and the fourth country in the world to ratify the WHO Framework Convention on Tobacco Control on 11th November 2003. The control of tobacco was further strengthened by the passage of the National Authority on Tobacco and Alcohol Control unanimously in the Parliament of Sri Lanka in 2006.
The way forward to end the tobacco menace.
1 Strengthen the NATA Act-
Strengthen current policies while addressing policy gaps.
Ban smoking in all public places – e.g. parks, beaches, shopping malls, markets etc. All public places to be included in the “No smoking zones. “
Ban on menthol flavoured cigarettes, e cigarettes, vaping machines, electronic nicotine devices must be implemented fully. Vigilance by custom officers at airports and sea ports is essential to confiscate these products to prevent circulation of these devices among school children.
2. Amendments to the NATA Act. Prohibition of the sale of single sticks of cigarettes completely. This is very important as single stick cigarettes circumvent the health warnings on packs and are much more affordable.
3 Establishment of “smoke free zones “in each MOH area in the country, where no sales of tobacco products occur. Currently, the target of one zone in each MOH area has been achieved. Target for 2 zones in each area in the future.
4 Introduction of “Smoke Free Generation” for children born from 2010 onwards. This was successfully passed in the parliament of the United Kingdom recently.
The Sri Lanka Medical Association, NATA, ADIC and the Temperance Association of Sri Lanka hope to give leadership to promote
“Smoke Free Generations” from 2010 in the parliament of Sri Lanka in the near future
5 Correct Taxation from the Tobacco Industry is mandatory
Over the last decade incorrect, inadequate and irrational taxation of tobacco has led to a loss of Rs 200 billion for the Sri Lankan government. (ADIC Press release 2021) If the government was able to collect this money as tax revenue, these funds could have been utilized for development projects – hospitals, schools, irrigation projects and highways, for the health, education and the economic well-being of its citizens. It is therefore imperative that treasury officials work independently and tax the tobacco industry correctly and rationally to prevent the country losing billions of tax money in the next budget.
I will conclude with the time-honored saying of David Byrne “The true face of tobacco is disease, death and horror “
Opinion
Tribute to Vijitha Senevirathna
APPRECIATION
On Friday, the 20th of March, Vijitha Senevirathna would have celebrated his 85th birthday if not for his sad passing away nearly a year ago.
The passing of Vijitha was a moment of great sorrow to all who knew him.
He was my classmate from Montessori to pre-university at Maris Stella College, Negombo. As a Maristonian, Vijitha excelled in his academic studies.
Eventually, he entered the Law College and practised as an Attorney-at-Law and Notary Public for over 50 years.
As an Attorney-at-Law, Vijitha earned the respect of the judiciary and a wide circle of clients. He upheld the highest and most cherished values of the legal profession and earned the trust of all who knew him. His 50th anniversary in the noble profession of law was celebrated with much pageantry, amidst a distinguished gathering of friends, relations, clerics, and the rich and famous of Sri Lanka.
Vijitha dearly loved his proud wife Nirmali and his six children, who are in the highest professions in Sri Lanka. He inculcated among his children professional efficiency, diligence, and honesty.
We who associated closely with Vijitha miss his warm friendship, sense of humor, and animated conversation. He was a raconteur, and people gathered around him and listened to his narrations and tales of yore, especially at the many celebrations at his residence in Dehiwala, where the waters of Scotland flowed generously.
I have personally admired Vijitha’s patience, grit, and lifetime achievements, despite a physical dysfunctionality he suffered over his lifetime.
For Vijitha, the song has ended, but the melody lingers on, in the words of the popular composer Irving Berlin.
Merrick Gooneratne
Opinion
Contrasting Strategy – Aggression vs support
China has invested more than USD 60 Billion in Venezuela and plans to invest further in that country. This is happening despite the abduction by the US of Venezuela’s president Maduro and his wife and US President Donald Trump’s boastful claim that he will be selling Venezuela’s oil. And what is even more surprising is that the Venezuelan Ambassador to China says nobody but Venezuela will decide the price of its oil and to whom it sells. He has assured that Chinese investments in his country will be safe and secure.
According to media reports, Venezuelan Ambassador to China, Remigio Ceballos, has stated that Venezuela will determine the price of its oil exports to China independently, asserting that prices will follow international market trends rather than dictates by the United States. Ceballos has stated that Caracas “will not heed the arrangements of the US or other countries” on oil pricing. The remarks followed reports that the U.S. is planning to exercise control over Venezuela’s state-run oil company, PDVSA, and potentially push prices down to $50 per barrel. Ceballos sought to reassure China that its investments in the South American country remained secure, emphasising that China and Venezuela are “trusted partners”. The ambassador clarified that despite geopolitical tensions, Venezuela would not follow Washington-led pricing structures, ensuring its oil remains competitive. These statements came in response to intense geopolitical maneuvering in early 2026 regarding Venezuela’s oil sector and its ongoing energy relationship with China (CNBC, 4th Feb. 2026).
Failure of agression
These developments reveal the failure of aggression in the face of support and cooperation. The US imposed crippling sanctions on Venezuela while China helped it to survive. Finally, true to form, the US did what it does best, take out the leader, like it did in Iraq, Libya and several other countries. Nowhere has this strategy succeeded, whereas the Chinese Belt and Road Initiative has been welcomed in most countries in Asia, Africa and the Middle East. China provides leadership in several key international associations and organisations designed to foster, or in some cases offer alternatives to, the existing global order. Key groupings include the Shanghai Cooperation Organization (SCO), BRICS, and the Asian Infrastructure Investment Bank (AIIB), alongside specialised UN agencies and regional forums like the Forum on China-Africa Cooperation (FOCAC). In contrast most of the US led organizations such as NATO, QUAD, AUKUS, are military alliances. Further, the US has defence agreements with several countries which are strategically vital for its interests, in the Middle East, Africa, Americas and Asia. China does not have a formal alliance requiring it to fight for another country. China adopts an anti-alliance policy and officially opposes NATO-like military alliances, arguing they create “small cliques” that cause confrontations in the region. China focuses on strategic partnerships rather than formal blocs, treating various countries as partners to avoid the confrontational nature of alliances.
With regards to aid, while the US focuses on capacity building China seems to believe that infrastructure development is more beneficial and would help the recipient country to develop its economy and be independent. Sri Lanka has experience with these US capacity building programmes and know that they are more often aimed at influencing the participants to change their political orientation and to be aligned with Western socio-political ideology. It is said that these programmes may have helped the US to bring about a regime change in the country. In Cambodia, too, the US has conducted capacity building programmes which the discerning Cambodians are suspicious of. China is the largest source of Foreign Direct Investment and top trading partner for Cambodia, with investment totaling over $23 billion by mid-2024, heavily focused on manufacturing, infrastructure, and real estate. Key projects under the Belt and Road Initiative include highways, hydroelectric dams, special economic zones, and the $1.7 billion Funan Techo Canal.
Bid to counter Chinese influence
The US attempts to counter the burgeoning advances of China by use of force. The abduction of President Maduro of Venezuela, the country with the largest oil deposits and increasingly coming under the influence of China, was its diabolical response. This criminal act shows the poverty of the US strategy. What it could do instead is develop cordial relations and respect the rights these countries must have in deciding on their socio-political structures and help them to come out of poverty without bullying and exploiting their resources. If that had been their policy no other country would have an opportunity to get a foothold in their backyard.
Iran joined the BRICS and was in the process of mending its fences with Saudi Arabia, a staunch ally of the US, with Chinese mediation. Saudi Arabia was also joining the BRICS, which is not well-disposed towards the US. China was planing to invest heavily in Iran. China and Iran signed a 25-year, $400 billion strategic cooperation agreement in 2021, aiming to boost energy and infrastructure.. The US and its ally in the Middle East, Israel, could not silently watch those developments that they saw as a threat to their hegemony and dominance in the region. The US felt the need to thwart the Chinese advance and also the growth of BRICS while Israel saw it as an opportunity to wipe out the opposition to its master plan of total genocide of Palestinians and grabbing their ancestral land in whole.
After killing Iranian supreme leader and bombarding the country into what they thought was submission, Trump said he must have a say in the appointment of the next leader and also that Ayatollah’s son was not acceptable to him. He demanded unconditional surrender of Iran and said there probably would not be anybody in Iran even to declare a surrender. Iran has not only said it will never surrender but also gone ahead and appointed the murdered supreme leader’s son as his successor. Trump said the Iranian navy was gone, its air force was gone, missile stockpiles were gone and it was already defeated. But Iran miraculously continues to fire missiles at Israel and US bases in the neighbouring countries.
Iran probably will be defeated in the war, but whether the US and Israel will achieve their goals is most unlikely. The underlying reason for this conflict is the problem of Palestine. The two-state solution adopted by the UN could be the basis for peace. The US knows this but it does not want peace in the Middle East. It can exploit the oil resources in the region by keeping it under eternal turmoil. This policy perfectly suits Israel as well and it exploits the situation to commit genocide of the Palestinians and grab their land.
In this era of multipolarity with several countries possessing long range missiles and nuclear capability and several of those countries being not in friendly terms with either US or Israel, re-arming, re-grouping and re-emerging of forces that will continue the anti-imperialist, anti-expansionist struggle cannot be prevented.
If only US, Europe emulate China
If the US and also the influential Europe could see how beneficial the policy adopted by China could be to everybody living on this planet, there would be peace in the world. This is what the Chinese have been telling the West while it engages in confrontation and aggression against those who do not fall in line and abide by their dictate. Chinese have shown their readiness to help everybody without discrimination, whether foe or friend of the US. China has significantly increased its investment in Saudi Arabia and other US allies in the Middle East, with 2024 seeing a record high in BRI (Belt and Road Initiative) engagement—reaching $39 billion in construction contracts and investments in the region. Saudi Arabia has emerged as the top recipient of Chinese investment, with over 93 projects initiated since 2021 despite it being one of the staunchest allies of the US in the Middle East with a large US military presence. The US has its largest military base in the Middle East in Qatar. Yet China has heavily invested in Qatar, primarily focusing on energy, infrastructure, and financial sectors. Major investments include Sinopec and CNPC securing stakes in Qatar’s North Field East LNG expansion projects, as well as significant participation in infrastructure projects like the Hamad Port and Lusail Stadium.
Vietnam, a victim of US aggression, has recently signed a defence cooperation agreement with it. Yet China has invested heavily in Vietnam, becoming a top source of foreign direct investment and leading in new projects as of 2025–2026. Chinese firms are investing billions in high-tech, electronics, and manufacturing in Vietnam, with over $6.7 billion pledged between January and November 2025.
Based on reports from international human rights organisations, the U.S. Department of State, and various news analyses, Saudi Arabia is widely considered a highly repressive, authoritarian country with intensified crackdown on political dissent, freedom of expression, and human rights activists. In 2016, the kingdom executed 146 people, including a mass execution of 47 men on January 2. The US says it’s attacking Iran because it is repressive, but in truth it is doing so because Iran does not toe its line, Saudi Arabia does and goes scot-free.
All in all, in this imperfect world what everybody must do is help each other disregarding their imperfections. If the US and also Europe try to emulate China, the world, in the least, would be safer.
(Some information contained in this article is from Wikipedia.)
by N. A. de S. Amaratunga
Opinion
Governance by beliefs
My father was an ardent believer of astrology. It was his hobby. As a result, not only my family, friends, and neighbours had horoscopes, but our pets also had their own. No need to say, my early life was choreographed according to celestial movements. When I sat for my ordinary level exam, father came up with an auspicious time to leave for the exam. This posed a huge logistical and psychological challenge. I was at Ananda hostel at that time, and he suggested that I leave at the auspicious time, which was more than an hour ahead of start time, sat in the basketball court until the doors open to the examination hall.
I told him no way. Not only that I would be laughingstock, but it would also disrupt the daily routine of study hall, breakfast, and arriving on time without wasting precious time, and disturbing the important mental harmony. By this time, I also had developed enough courage not to accept tradition without justification, mainly thanks to Ven. Kotagama Wachissara thero, our Dhamma teacher. It must have hurt his feelings, but my father backed out. I did well in the exam, and that was the last time I had anything to do with astrology.
Not exactly, when we got married, our parents came up with an auspicious time for the traditional ceremony, but due to a logistical hitch, we missed it. Not to worry, after five decades, the spark has not left and things are going smoothly. Since then, we have moved across continents, taken up jobs, moved into houses, and brought up kids without the assistance of astrology. Similarly, I know countless people who lead successful, happy, and prosperous lives without ever having heard of astrology.
Vedic Astrology, also called Jyotish, originated over 5,000 years ago in India. It is deeply rooted in the Vedas, ancient Hindu scriptures. Western Astrology began around 2,000 years ago in Mesopotamia and developed further in Greece and Rome. For millennia, humanity has tried to correlate celestial movements with terrestrial events, especially seasonal changes, for the benefit of agriculture, maritime navigation, and trade over long distances. This “mundane astrology” was a practical effort to bring order to a chaotic world. Naturally, the ancients extended this study to interpret the effect of celestial events on the individual. Vedic Astrology emphasises spiritual growth, while Western Astrology focuses on personality and psychological traits.
Until the 17th century, astrology and astronomy were virtually indistinguishable. Great scientists like Johannes Kepler and Isaac Newton practised astrology or lived in a world where it was considered a legitimate academic discipline. However, Enlightenment, or the Age of Reason in the 17th–18th century, which emphasises reason, individualism, and skepticism toward tradition introduced a rigorous scientific method that astrology could not satisfy. From a physical standpoint, the gravitational or electromagnetic influence of distant planets on a newborn human is negligible compared to the influence of the immediate environment. Parenting, education, and social background, for example.
Consequently, the scientific community classifies astrology as a pseudoscience, noting that its predictions rely on the tendency for people to find personal meaning in vague, generalized statements. Once a person starts believing this system, they tend to seek out and remember information that confirms their beliefs while ignoring or rationalising the many times the predictions were wrong. Phrases like “You will go through a difficult time during such a period” feel personal, but who would not go through challenging times in their lives. This is called the Barnum Effect. In times of high stress or uncertainty, astrology provides a sense of structure and predictability, making a chaotic world feel more manageable.
Vedic Astrology uses the sidereal zodiac, which aligns with the actual positions of stars and constellations. In contrast, Western Astrology relies on the tropical zodiac, based on the Earth’s seasons. The sidereal zodiac reflects fixed star positions, while the tropical zodiac shifts due to the Earth’s axial precession. Unlike my father, I know nothing about astrological calculations, but I wonder if the current disagreement on the New Year auspicious times is a result of following such different methods.
There is some validity in having a unified timetable for major events as it can coordinate and bring together a community, or an entire nation in this case. It is a good thing. However, it cannot be denied that astrology is a belief system that the individual must decide to accept or reject depending on their own wishes. Expecting the government to take any part in endorsing a belief system that has absolutely no empirical evidence goes beyond lunacy. Where would it stop? Do we expect the government to decide the auspicious time to get married, indula katagema, or akuru kiyaweema of children? Instead, we must demand our government get out of pandering to belief systems of any nature and focus on the business of governance based on facts and figures.
In our household, we celebrate New Year to suit our lifestyle: we cook a special meal, but on the same old stove, at our convenience so that it does not disrupt the regular mealtimes and share it with family and friends. It is a social event for sharing fun and goodwill. We tell the children about the traditions, how they started, and the food, but we do not expect them to subscribe to any belief systems and engage in meaningless activities that waste their time and resources. We expect them to grow up to be realistic, yathabutha, not bahubutha, as my grandfather would have said.
by Geewananda Gunawardana
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